Government Regulation of Nursing Homes

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The Center for Medicare & Medicaid Services (CMS) is the component of the Federal Government's Department of Health and Human Services that oversees the Medicare and Medicaid programs. A large portion of Medicare and Medicaid dollars is used each year to cover nursing home care and services for the elderly and disabled. State governments oversee the licensing of nursing homes. In addition, States have a contract with CMS to monitor those nursing homes that want to be eligible to provide care to Medicare and Medicaid beneficiaries. Congress established minimum requirements for nursing homes that want to provide services under Medicare and Medicaid. These requirements are broadly outlined in the Social Security Act (the Act). The Act also entrusts the Secretary of Health and Human Services (DHHS) with the responsibility of monitoring and enforcing these requirements. CMS, a DHHS Agency, is also charged with the responsibility of working out the details of the law and how it will be implemented, which it does by writing regulations and manuals.

CMS contracts with each State to conduct onsite inspections that determine whether its nursing homes meet the minimum Medicare and Medicaid quality and performance standards. Typically, the part of State government that takes care of this duty is the health department or department of human services. In Kansas, the Secretary of Health and Environment is responsible for protecting the health and safety of nursing care institutions. The State conducts inspections of each nursing home that participates in Medicare and/or Medicaid. Nursing homes pursuant to the social security act are required to cooperate with the Department of Health and Environment in mandatory inspections every 15 months under the Omnibus Budget Reconciliation Act Kan. Stat. Ann. § 39-935 If the nursing home is performing poorly, however, the State inspectors may go in more frequently. The State also investigates complaints about nursing home care. During the nursing home inspection, the State looks at many.phpects of quality. The inspection team observes resident care processes, staff/resident interaction, and environment. Using an established protocol of residential rights, the team interviews a sample of residents and family members about their life within the nursing home, and interviews caregivers and administrative staff. The team reviews clinical records. Kan. Stat. Ann. § 39-935

The inspection team consists of trained inspectors, including at least one registered nurse. This team evaluates whether the nursing home meets individual resident needs. The regulations cover a wide range of.phpects of resident life, from specifying standards for the safe storage and preparation of food to protecting residents from physical or mental abuse or inadequate care practices. There are over 150 regulatory standards that nursing homes must meet at all times. Many are related. In addition, fire safety specialists evaluate whether a nursing home meets standards for safe construction. When an inspection team finds that a home does not meet a specific regulation, it issues a deficiency citation. After each inspection the Department of Health issues a quality rating based on the quality of service provided by the facility Every adult care home must post in a conspicuous place a notice indicating that the most recent inspection report and related documents may be examined in the office of the administrator of the adult care home. Upon request, every adult care home shall provide to any person a copy of the most recent inspection report and related documents, provided the person requesting such report agrees to pay a reasonable charge to cover copying costs. Kan. Stat. Ann. § 39-935

If the State finds any violations of nursing home regulations, they may fine the nursing home operator up to $100. Kan. Stat. Ann. § 39-943.

The Pistotnik Law Offices, P.A. is committed to upholding the quality of care in our long-term care institutions by taking swift legal action to compensate nursing home residents and their families for injuries resulting from neglect or inadequate care. Only this way will the quality of care for all residents be assured. If you feel that you or a loved one has been victimized by medical malpractice while in the care of a senior citizen facility, call The Pistotnik Law Offices, P.A. now at (877) 733-2723 or CLICK HERE TO SUBMIT A SIMPLE CASE FORM. The initial consultation is free of charge, and if we agree to accept your case, we will work on a contingent fee basis, which means we get paid for our services only if there is a monetary award or recovery of funds. Don't delay! You may have a valid claim and be entitled to compensation for your injuries, but a lawsuit must be filed before the statute of limitations expires.

The Pistotnik Law Offices handles all personal injury cases including, but not limited to:Large truck accidents, car accidents, injury cases, injury victims, reckless driving, negligence, torts, car accident victims, damages, wrongful death, vehicle accidents, pedestrians, cyclists, motorcycle accidents, third party lawsuits, damaged cars, insurance settlements, auto accidents, medical bills, permanent injury, rear-end collisions, liability insurance, property damage, minor injuries, insurance coverage, truck accident, tractor-trailer accidents, paralysis, paralyzed, eaglemed, Lifeflight, Wesley Medical Center, Via Christi, St. Francis hospital.

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